Interaction Effects Between Dietary Inflammatory Index And Physical Activity On Sleep Quality In College Students

Objective To investigate the dietary inflammatory tendency,physical activity level and sleep quality in college students;to explore the dietary inflammation index（DII）,physical activity and the influence of their interaction on sleep quality.Methods 905 Students studying at a Medical University from April 2022 to November2022 were selected and included in the study.General demographic information and life behaviors,such as age,height,weight,gender,grade,smoking and drinking alcohol were collected using the general demographic questionnaire.The International Physical Activity Questionnaire-Short Form（IPAQ-SF）was used to investigate the physical activity level of college students.The Pittsburgh Sleep Quality Index（PSQI）questionnaire was used to survey the sleep quality of college students in the past one month.The 24-h dietary recall for continuous 3 days was used to investigate the dietary intake of college students.All dietary data were analyzed for average daily intake of various food components/nutrients with an analysis software,followed by calculation of DII according to previous reports.The binary Logistic regression model were used to explore the relationship between DII,physical activity and sleep quality in college students.In the interaction analysis,with DII and physical activity as 2 interaction terms,a Logistic regression model was established to analyze the effect of interaction on sleep quality.Results（1）The PSQI scores of college students ranged from 0 to 15,with the average PSQI score of（5.02±2.46）.After grouping by 7 points,136（15.03%）were in sleep disorder group（PSQI>7）and 769（84.97%）in non-sleep disorder group（PSQI≤7）.There was a significant difference between the groups in grade and smoking status（P<0.05）.No significant differences were identified in age,BMI,gender,only child,marital status,family residence,monthly income,emotional status and alcohol consumption in the two groups（P>0.05）.（2）The total DII scores of college students ranged from-0.67 to 3.78,with a mean DII of 2.53±0.56.They were divided according to the total score of DII,and the three groups were anti-inflammatory diet group（T₁group:DII<2.37）,the middle group（T₂group:2.37～2.83）,and pro-inflammatory diet group（T₃group:DII>2.83）.There was a significant difference among the three groups only in gender（P<0.05）.No significant differences were identified in age,BMI,grade,only child,marital status,family residence,monthly income,emotional status,smoking and alcohol consumption among the three groups（P>0.05）.（3）A total of 173（19.12%）were in high-intensity physical activity group,536（59.23%）in medium-intensity group and 196（21.65%）in low-intensity group.There was a significant difference among the three groups in gender and grade（P<0.05）.No significant differences were identified in age,BMI,only child,marital status,family residence,monthly income,emotional status,smoking and alcohol consumption in the three groups（P>0.05）.（4）A binary Logistic regression analysis was performed with PSQI score as the dependent variable and DII as the independent variable.The results showed that compared with T₁group,the OR（95%CI）of sleep disorder risk in T₃group was 2.31（1.46～3.64）.After adjusting for confounding factors,the OR（95%CI）was 2.36（1.47～3.79）.（5）A binary Logistic regression analysis was performed with PSQI score as the dependent variable and physical activity as the independent variable.The results showed that compared with high-intensity physical activity group,the OR（95%CI）of sleep disorder risk in low-intensity physical activity group was 3.31（1.83,5.99）.After adjusting for confounding factors,the OR（95%CI）was 3.19（1.72,5.91）.（6）A binary Logistic regression analysis was performed with PSQI score as the dependent variable and subgroup 1（anti-inflammatory diet high-intensity physical activity group）was used as the control group.The results showed that compared with subgroup 1,the OR（95%CI）of sleep disorder risk in subgroup 9（pro-inflammatory diet low-intensity physical activity group）was 6.99（2.69,18.16）.After adjusting for confounding factors,the OR（95%CI）was 7.43（2.75,20.10）.Conclusion This study has drawn the following conclusions:（1）College students have problems with sleep quality and 15.03%of college students have reached the level of sleep disorders.（2）The overall diet tendency of college students is mainly pro-inflammatory and the problem of unreasonable diet structure is common.（3）The physical activity of college students is mainly moderate-intensity and its needs to be strengthened.（4）Pro-inflammatory diet is a risk factor for sleep disorders.（5）Low-intensity physical activity is a risk factor for sleep disturbance.（6）There is an interaction between DII and physical activity on sleep quality,and the simultaneous occurrence of low-intensity physical activity and pro-inflammatory tendency diet can increase the risk of sleep disorder in college students.